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Changes in common mental disorders and diagnosis-specific sickness absence: a register-linkage follow-up study among Finnish municipal employees
  1. Elina Mauramo1,
  2. Jouni Lahti1,
  3. Tea Lallukka1,2,
  4. Eero Lahelma1,
  5. Olli Pietiläinen1,
  6. Ossi Rahkonen1
  1. 1 Department of Public Health, University of Helsinki, Helsinki, Finland
  2. 2 Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to Dr Elina Mauramo, Department of Public Health, University of Helsinki, Helsinki 00100, Finland; elina.mauramo{at}


Objective This study examined the associations between changes in common mental disorders (CMD) and subsequent diagnosis-specific sickness absence (SA) among midlife and ageing municipal employees.

Methods Data from the Helsinki Health Study phase I (2000–2002) and phase II (2007) surveys among employees of the City of Helsinki, Finland, were linked with prospective register data from the Social Insurance Institution of Finland on diagnosis-specific (mental, musculoskeletal, other causes) SA (n=3890). Associations between change in CMD (General Health Questionnaire 12) from phase I to phase II and the first SA event in 2007–2014 were analysed using Cox regression modelling. Sociodemographic, work and health-related covariates from phase I, and SA from the year preceding phase I were controlled for.

Results Having CMD at one or two time points, that is, favourable and unfavourable change in CMD and repeated CMD, were all associated with a higher risk of SA due to mental, musculoskeletal and other diagnoses compared with women and men with no CMD. Favourable change in CMD reduced the risk of SA when compared with repeated CMD. The strongest associations were observed for repeated CMD (HR range: 1.44 to 5.05), and for SA due to mental diagnoses (HR range: 1.15 to 5.05). The associations remained after adjusting for the covariates.

Conclusions Changing and repeated CMD increased the risk of SA due to mental, musculoskeletal and other diagnoses. CMD should be tackled to prevent SA and promote work-ability among ageing employees.

  • mental health
  • sickness absence
  • longitudinal studies
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  • Contributors All authors meet the criteria of authorship. EM led the study and JL, TL, EL, OP and OR participated in planning of the study and the analyses. EM wrote the first draft of the manuscript and the revised versions. JL conducted the analyses. All authors interpreted the results. JL, TL, EL, OP and OR reviewed, commented and revised the manuscript. All authors approved the submission of the final manuscript to the journal.

  • Funding EM was supported by The Finnish Work Environment Fund (Grant #116490). JL was supported by the Academy of Finland (Grant #1294566). TL was supported by the Academy of Finland (Grants #287488 and #319200) and by the Finnish Work Environment Fund (Grant #117308). OR was supported by the Academy of Finland (Grant #1294514) and Juho Vainio Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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